NCG080156 DMR SW (4)

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG080000
Date submitted i l a a o 110
CERTIFICATE OF COVERAGE NO. NCG08 0 1 S (o
FACILITY NAME )circ Tru+vnioi j Ce A4cr
COUNTY We, 1LL
PERSON COLLECTING SAMPLES C -,A i do ' Cw wCl e%
LABORATORY-Nt.eAM4AA ,a , G --c. tC„v, Lab Cert. # 04 , Slti 0
Comments on sample collecfion or analysis:
SAMPLE COLLECTION.YEAR a 0 IS
SAMPLE PERIOD ❑ Jan -June, Z July -Dec
or ❑ Monthly' (month)
FSV ING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
JAN'2 5 2016 ®Other C,
-
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4
DWR SECTION V/no
this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes _no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) .
[�r/No discharge this period'
Outfall Date00530
No. Sample Collected,
mo/dd/yr. .
00556
00400
00556 .
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT -HEM), mgjL
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT -HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark -
50 or 100 see permit .
Within 6.0 — 9.0
15
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall Date
No. Sample Collected,
mo/dd/yr . , .
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT -HEM), mgjL
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit -
15
50 or 100 see. permit
6.0-9.0
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Pagel of 2

"4
STORM EVENT CHARACTERISTICS:
Date (first event sampled)
Total Event Precipitation (inches):
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation'(inches):
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See: General Permit text.
FOR PARTA AND PART B MONITORING RESULTS:-
• A BENCHMARK EXCEEDANCE TRIGGERS TIER_1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES Q NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriaina/ and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in
the case of "No Discharae" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail:5ervice Center .
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure
that qualified personae rop rly.gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible f r t ring the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that
there are significan /p al es for submitting false information, including the possibility of fines and imprisonment for knowingviolations."
t
(Signature of P r Otte (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/webwq/ws/su/nodessw#tab-4
SWU-250 last revised April 11, 2013
Page 2 of 2 ,...